Purpose: It has recently been shown that chronic noninvasive ventilation (NIV) improves a number of outcomes including survival, in patients with stable hypercapnic COPD. However, the mechanisms responsible for these improved outcomes are still unknown. The aim of the present study was to identify parameters associated with: 1) an improved arterial partial pressure of carbon dioxide (PaCO) and 2) survival, in a cohort of hypercapnic COPD patients treated with chronic NIV.
Patients And Methods: Data from 240 COPD patients treated with chronic NIV were analyzed. Predictors for the change in PaCO and survival were investigated using multivariate linear and Cox regression models, respectively.
Results: A higher level of bicarbonate before NIV initiation, the use of higher inspiratory ventilator pressures, the presence of anxiety symptoms, and NIV initiated following an exacerbation compared to NIV initiated in stable disease were associated with a larger reduction in PaCO. A higher body mass index, a higher FEV, a lower bicarbonate before NIV initiation, and younger age and NIV initiation in stable condition were independently associated with better survival. The change in PaCO was not associated with survival, neither in a subgroup of patients with a PaCO >7.0 kPa before the initiation of NIV.
Conclusion: Patients with anxiety symptoms and a high bicarbonate level at NIV initiation are potentially good responders in terms of an improvement in hypercapnia. Also, higher inspiratory ventilator pressures are associated with a larger reduction in PaCO. However, the improvement in hypercapnia does not seem to be associated with an improved survival and emphasizes the need to look beyond PaCO when considering NIV initiation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219270 | PMC |
| http://dx.doi.org/10.2147/COPD.S169951 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impact of mechanical ventilation on severe acute kidney injury in critically ill patients with and without COVID-19 - a multicentre propensity matched analysis.
Ann Intensive Care
January 2025
Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
Background: Acute kidney injury (AKI) is common in critically ill patients and is associated with increased morbidity and mortality. Its complications often require renal replacement therapy (RRT). Invasive mechanical ventilation (IMV) and infections are considered risk factors for the occurrence of AKI.
View Article and Find Full Text PDFConstraints to the initiation of home non-invasive ventilation and short-term efficacy in different diagnostic groups (as a prelude to an ambulatory shift).
Respir Med Res
January 2025
Department of Respiratory and Sleep Medicine, Angers University hospital, Angers, France; MitoVasc, Carme, SFR ICAT, CNRS 6015, Inserm 1083, University of Angers, Angers, France. Electronic address:
Introduction: Non-invasive ventilation (NIV) is the reference treatment for chronic respiratory failure (CRF) due to impairment of the ventilatory system. Home initiation is increasingly practiced. To better support this ambulatory shift, we aimed to assess the implementation constraints and short-term efficacy according to different aetiologies of CRF.
View Article and Find Full Text PDFPatients' choices regarding ventilatory support affect opioid use in amyotrophic lateral sclerosis.
Amyotroph Lateral Scler Frontotemporal Degener
January 2025
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Objective: To investigate the impact of different ventilatory support options on opioid use among patients with amyotrophic lateral sclerosis (ALS).
Methods: We retrospectively reviewed 889 consecutive patients with ALS and enrolled 399 eligible patients. All patients were followed until death or tracheostomy.
Molecular modelling and optimization of a high-affinity nanobody targeting the nipah virus fusion protein through in silico site-directed mutagenesis.
Comput Biol Chem
January 2025
Virology and Vaccine Research and Development Program, Department of Science and Technology-Industrial Technology Development Institute, Taguig City, Metro Manila 1631, Philippines; S&T Fellows Program, Department of Science and Technology, Taguig City, Metro Manila 1631, Philippines; Department of Biology, College of Arts and Sciences, University of the Philippines - Manila, Metro Manila 1000, Philippines. Electronic address:
Nipah virus (NiV) is a re-emerging zoonotic pathogen with a high mortality rate and no effective treatments, prompting the search for new antiviral strategies. While conventional antiviral drugs are often limited by issues such as poor specificity, off-target effects, and resistance development, nanobodies offer distinct advantages. These small, single-domain antibodies exhibit high specificity and stability, making them ideal candidates for antiviral therapy.
View Article and Find Full Text PDFRisk factors for noninvasive ventilation failure in preterm infants at less than 30 weeks of gestation with respiratory distress syndrome.
J Trop Pediatr
December 2024
Division of Neonatology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, 06800, Turkey.
This study aimed to identify risk factors for noninvasive ventilation (NIV) failure in <30 weeks' gestation preterm neonates and compare morbidity in patients with and without NIV failure. This study included preterm neonates <30 weeks' gestation who received NIV support for respiratory distress syndrome (RDS). Demographic and clinical characteristics were compared between infants with and without NIV failure within the first 72 hours after birth.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!